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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

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How ICD-10 Affects You

For Patients

How will the switch to ICD-10 affect you and your family?

Every time you see your doctor or go to the hospital emergency room for care, a note is written in your medical record about why you came in, what kind of health problem you have and how the problem will be treated.

These notes about your health are put into medical codes for the doctors and medical staff to use for many purposes. The most common is to bill insurance companies for your care. Another use is to count the number of people who are experiencing a health problem at the same time, like during flu season. The Centers for Disease Control and Prevention (CDC) use this information to alert patients to get their flu shot.

On October 1, 2015 most of the health care industry, including IHS, Tribal and Urban programs will stop using the ICD-9 medical codes and begin using the new ICD-10 codes. This change will provide better and more detailed information about your health care.

Example: If you break your arm,

In ICD-9
There is no code to describe which arm is broken.

In ICD-10
One code will describe which arm is broken, the bone that is broken, and if this is the first visit to treat the break or a follow-up visit. If it is a follow-up visit, information about how well the bone is healing is included in the code. You may see these codes on your Explanation of Benefits that is sent to you by your health insurance company. To read more about the transition from ICD-9 to ICD-10, see the CMS website on ICD-10 .

To read more about the transition from ICD-9-CM to ICD-10-CM, see the CMS website on ICD-10 .

For Providers

How will the switch to ICD-10 affect you and your patient?

For you, as a provider, the switch to ICD-10 from ICD-9 will not really change the way you practice medicine. The switch to ICD-10 will occur in the background of RPMS. You already understand the importance of clear, concise documentation and have used it to document in ICD-9. Occasionally, the coder at your facility may request more information about a patient's condition and you will realize that writing the required level of detail at the point of care saves you and the coder an enormous amount of time.

Basically, good documentation is about good patient care. Quality documentation impacts quality measures, provides information on how to manage your patient population, and ensures improved billing accuracy that will result in fewer payment denials.

Resources

ICD-10, The Provider Perspective

ICD-10 Clinical Documentation Supporting good patient care and proper coding in an ICD-10 environment

American Academy of Family Physicians (AAFP) ICD-10 Exit Disclaimer: You Are Leaving www.ihs.gov

American College of Physicians (ACP) ICD-10 Exit Disclaimer: You Are Leaving www.ihs.gov

CMS.gov Centers for Medicare & Medicaid Services ICD-10 Exit Disclaimer: You Are Leaving www.ihs.gov

Indian Health Service RPMS Training Website